Among hypertensive patients, women had significantly lower adjusted odds of all-cause mortality (OR 0.77) and cardiovascular mortality (OR 0.80) compared to men, despite lower therapeutic compliance.
Cohort (n=232,507)
Does female gender affect medication consumption and mortality in hypertensive patients?
Among hypertensive patients, women have higher treatment rates but lower therapeutic compliance and lower all-cause and cardiovascular mortality compared to men, with differences strongly dependent on age.
Odds Ratio: 0.77 (95% CI 0.72–0.82)
Absolute Event Rate: 2.81% vs 1.74%
BACKGROUND: This paper aims to assess the presence of gender differences in medication use and mortality in a cohort of patients affected exclusively by hypertension, in 193 municipalities in the Lombardy Region (Northern Italy), including Milan's metropolitan area. METHODS: A retrospective cohort study was conducted (N = 232,507) querying administrative healthcare data and the Register of Causes of Death. Hypertensive patients (55.4% women; 44.6% men) in 2017 were identified; gender differences in medication use (treatment, 80% compliance) and deaths (from all causes and CVDs) were assessed at two-year follow-ups in logistic regression models adjusted for age class, census-based deprivation index, nationality, and pre-existing health conditions. Models stratified by age, deprivation index, and therapeutic compliance were also tested. RESULTS: Overall, women had higher odds of being treated, but lower odds of therapeutic compliance, death from all causes, and death from CVDs. All the outcomes had clear sex differences across age classes, though not between different levels of deprivation. Comparing patients with medication adherence, women had lower odds of death from all causes than men (with a narrowing protective effect as age increased), while no gender differences emerged in non-compliant patients. CONCLUSIONS: Among hypertensive patients, gender differences in medication consumption and mortality have been found, but the extent to which these are attributable to a female socio-cultural disadvantage is questionable. The findings reached, with marked age-dependent effects in the outcomes investigated, suggest a prominent role for innate sex differences in biological susceptibility to the disease, whereby women would take advantage of the protective effects of their innate physiological characteristics, especially prior to the beginning of menopause.
Consolazio et al. (2022) conducted a cohort in Hypertension (n=232,507). Female sex vs. Male sex was evaluated on All-cause mortality (OR 0.77, 95% CI 0.72-0.82). Among hypertensive patients, women had significantly lower adjusted odds of all-cause mortality (OR 0.77) and cardiovascular mortality (OR 0.80) compared to men, despite lower therapeutic compliance.